Prematurity Prevention Clinic

(801) 213‑2995

Utah Preterm Birth Prevention Clinic

The Utah Preterm Birth Prevention Clinic represents a collaboration between the University of Utah and Intermountain Health Care to provide cutting-edge information and technology to prevent one of the most common and serious complications of pregnancy. If you have experienced a preterm birth in the past or if you believe that you are at increased risk for preterm birth, the Utah Preterm Birth Prevention Clinic will perform a comprehensive and in-depth evaluation of your risk and outline a treatment plan for your pregnancy to minimize your risk of experiencing a preterm birth.

If you or your health care provider believe you are at increased risk for preterm birth or if you have previously experienced a preterm birth, please contact our office coordinator to arrange a consultation at your earliest convenience.

Contact Us

For patients coming to the University of Utah, please call the Maternal-Fetal Medicine office at (801) 581-8425. Alternatively, you could ask your current physician for a referral to the clinic, and we would be happy to see you as soon as possible. For Intermountain Health Care, call Maternal-Fetal Medicine office at IMC at (801) 507-7400.

Maternal Fetal Medicine Division office:

(801) 581-8425

Clinical & Ultrasound Appts:

(801) 581-7746

Labor & Delivery:

(801) 581-2452

OB Emergency Services:

(801) 587-9500

Pregnancy Risk Line:

(801) 328-2229 or 1 (800) 822-2229

Prematurity Prevention Clinic is located at University of Utah Hospital in the Maternal Fetal Diagnostic Clinic:

Preterm Birth: What You Need to Know

What is preterm birth?

Preterm birth refers to the delivery of a pregnancy prior to its due date. Because some babies are delivered prematurely because of maternal and/or fetal complications, it is important to distinguish between indicated preterm birth and spontaneous preterm birth. In this clinic we will focus primarily on spontaneous preterm birth.

In the strictest sense, spontaneous preterm birth refers to any baby that is born more than three weeks prior to the expected due date. If you have experienced a delivery or birth at less than 20 weeks gestation, this is considered to be a miscarriage. Any delivery that occurs from 20 weeks gestation up through 36 weeks gestation is considered premature.

In order to determine whether or not a pregnancy has delivered prematurely, it is important to accurately assign a gestational age. This can be accomplished by following a woman’s menstrual history and calculating a due date based on a known date for the beginning of her last menstrual period. Ideally, ultrasound evaluation of the pregnancy, including measurements of the growing fetus, will confirm the same gestational age that was calculated based on the patient’s last menstrual period. However, in cases where the due date that is calculated by an early ultrasound is different from the last menstrual period due date, the ultrasound due date is generally considered most accurate.

What causes preterm birth?

Some definitions of preterm birth use birth weight as criteria. Any infant that is born with a birth weight of 2500 grams or less is considered to be premature. Other possible causes of preterm birth are the following:

Maternal or fetal stress

Infection or inflammation

Vaginal bleeding that comes from within the uterus

Over distension of the uterus as may be found with twins or triplets or excess amniotic fluid

When spontaneous preterm birth occurs at a very early gestational age (between 20 and 32 weeks gestation) the most common identifiable cause is infection or inflammation. In some cases bacteria or viruses have caused an infection within the uterus, vagina, bladder or some other part of the body that results in preterm delivery. However, some cases of preterm delivery are the result of an inappropriate or abnormal or inflammatory response by the mother to relatively normal vaginal or cervical bacteria. Even infection or inflammation in the gums of the mouth and around the teeth (called periodontal disease) has been associated with preterm delivery.

Although in many cases of preterm birth, it is not possible to identify the exact cause of preterm birth, a complete history—including information and details about the timing and symptoms that were present at the time of a preterm delivery in the past—may help. A detailed review of medical records that are available may also help to pinpoint a cause of a previous preterm birth.

What is my risk of preterm birth?

It is possible by taking a thorough history and review of previous pregnancies to determine the exact risk or approximate risk of a recurrence of preterm birth. Several known risk factors have been reported for preterm birth, the most significant of which is a previous history of preterm birth. In a woman who has experienced one previous preterm birth in her last pregnancy, the recurrence risk for another preterm birth is approximately 35–40 percent. Other risk factors for early delivery include the presence of twins or triplets, fetal abnormalities that can result in excess amniotic fluid, known uterine abnormalities (such as an abnormal shape to the uterus or cervix), vaginal bleeding during the pregnancy and premature rupture of the membranes.

During your first visit at the Utah Preterm Birth Prevention Clinic, you will meet with a Maternal-Fetal Medicine specialist who will take a detailed history from you and review your records and ultimately quote you a specific risk for your current pregnancy for the recurrence of preterm birth.

What are the risks for my baby if it is born too early?

Preterm birth and preterm delivery are the most common cause of neonatal death, and long-term complications including bleeding into the brain, blindness, deafness, problems with the lungs and problems with the intestines. The type of complications that may be experienced by your preterm infant can only be determined by the exact time of delivery and any other complicating factors that may have been involved with your delivery.

In general, infants that are born very early are not considered to be “viable” until after 24 weeks gestation. This means that an infant that delivers prior to 24 weeks in a pregnancy will likely have less than a 50 percent chance of survival. Those infants born before 24 weeks gestation that do survive will have a very high risk of severe long-term problems as a result of their preterm delivery.

At 24 weeks gestation, in an otherwise uncomplicated pregnancy, the expected survival rate ranges between 60 and 70 percent. Of those infants that deliver prematurely at 24 weeks gestation and survive, about 40 percent will suffer some type of long-term complication as a result of their prematurity. If a patient is able to remain pregnant for as little as two to three weeks, the risk of neonatal death decreases substantially as does the risk for long-term complications. At 28 weeks gestation, in an otherwise uncomplicated pregnancy, delivery will result in a survival rate for the infant of 80–90 percent and long-term complication rate of only 10 percent among survivors. By the time the fetus reaches 32 weeks gestation and delivers at 32 weeks gestation, survival rates are as high as 95 percent and long-term morbidity is very low.

The long-term outcome for infants born after 34 weeks gestation would be the same as those delivered at term. It is important to know that 34-week infants will likely require some hospital stay as long as one to two weeks in the Newborn Intensive Care Unit, but in long-term follow-up, these infants do very well and likely will have the same outcome as an infant delivered at term. Any infant that is born at less than 34 weeks gestation would be expected to spend an extended period of time in the Newborn Intensive Care Unit, on average until three to four weeks before what their due date would have been.

If you previously experienced a preterm birth, you are well aware of the complications and problems that are faced by premature infants. It is important to note that in subsequent births, it is not necessary to completely prevent preterm birth to have a major impact on the outcome of the infant. If we are able to delay your delivery by as little as one to two weeks, there may be substantial improvement in the outcome of the infant.

How can preterm birth be prevented?

This is a question that has been posed by many researchers and obstetricians for many years. It is unlikely that any one intervention or treatment will prevent all preterm births. This is due to the fact that preterm birth has multiple causes, and likely one treatment will not be adequate for the multiple causes that can exist. Recent studies have shown that treatment with a hormone named progesterone (a steroid hormone that is naturally produced by the placenta and by the mother herself) can reduce the rate of preterm birth by as much as 30–50 percent.

The use of corticosteroids to hasten lung maturity and prevent other complications of prematurity in infants that are at-risk for preterm birth has also been shown to make a substantial improvement in long-term outcomes of infants. The timing and route of delivery of the corticosteroids is something that must be determined on a case-by-case basis. There is also substantial evidence to suggest that initiation of early prenatal care and close monitoring may reduce the rate of preterm birth in some populations. Early evaluation and consultation in the Utah Preterm Birth Prevention Clinic will allow you to initiate the interventions that are available in an optimal fashion and will maximize the benefit of the potential reduction of preterm birth.

When should I be seen in the clinic?

Any person who is pregnant regardless of their risk of preterm birth should be seen ideally in the first 12 weeks of pregnancy. The first visit in the Utah Preterm Birth Prevention Clinic should occur between 10 weeks gestation and 18 weeks gestation to allow for adequate documentation of the estimated due date, a thorough analysis and physical exam to identify risk factors including risks associated with previous preterm deliveries and to detect the presence of inflammation or infection at this time. We would hope to talk with you either before your pregnancy or in the first 18 weeks of your pregnancy to improve the chance of reducing the preterm birth.

What are the signs and symptoms of preterm birth?

The most common signs of preterm birth include the presence of regular uterine contractions. Some women describe these symptoms as severe menstrual-type cramps that occur in the lower part of the abdomen. Alternatively, intermittent tightening in the abdomen in a band-like fashion that begins in the lower back and radiates around to the anterior portion of the lower abdomen has also been described. Other symptoms include vaginal pressure, change in vaginal discharge and vaginal bleeding or loss of fluid. It’s not uncommon for women to experience preterm contractions beginning as early as 23–24 weeks gestation. However, when these contractions occur in a regular fashion (less than every 10 minutes) or occur in a frequency more than six contractions per hour, they should be evaluated, as frequently some intervention will be necessary. If you have had a previous history of preterm birth and you are experiencing regular uterine contractions, pelvic pressure, change in your vaginal discharge or vaginal bleeding or loss of fluid, you should contact your provider immediately.

Does preterm birth run in families?

There is ample evidence to suggest that preterm birth does run in families. Women who were themselves born early are at increased risk of delivering their own infants early as well. Recent data has also shown that sisters and female cousins of women have experienced a preterm birth are at increased risk of having a preterm birth themselves. If you or a member of your family has previously experienced a preterm birth, please contact the clinic to allow us to assess your risk of preterm birth.

Are there any risks for the mother as a result of preterm birth?

Preterm deliveries are more likely to be the result of complications such as infection or abruption (a condition in which the placenta detaches from the uterine wall prematurely). These complications have implications for the mother as well. Mothers may experience significant infection that requires IV antibiotic treatment and in some may become life threatening. Spontaneous preterm birth is more likely to require a Cesarean section due to the fact that early infants often are found in breech presentation or some other abnormal presentation. Preterm babies sometimes do not tolerate labor well and are also at increased risk for cesarean delivery because of this as well.

Do I need to transfer my care from my regular obstetrician?

The Utah Preterm Birth Prevention Clinic is purely a consultation clinic. We would hope that you would continue your regular obstetric care and obstetric visits with your current OB provider. The Utah Preterm Prevention Clinic will provide a detailed report to your physician outlining the risk factors and work-up and interventions that are recommended. If you were to participate in the Preterm Birth Prevention Clinic, you would make three visits during the time of your pregnancy. The first would occur from between the time of conception to 18 weeks gestation. The second visit would occur between 22 and 26 weeks gestation and the third visit would occur between 26 and 32 weeks gestation. Each of these visits is designed to screen for evidence of infection or other risk factors that may be associated with an increased risk of preterm birth.

What research protocols are currently available for women at risk for preterm birth?

The Utah Preterm Birth Prevention Clinic represents cooperation between the University of Utah and Intermountain Health Care. Both the University of Utah and Intermountain Health Care have a long history of participation in clinical trials that have made landmark discoveries regarding preterm birth. The physicians that manage and direct the Utah Preterm Birth Prevention Clinic also participate in multi-center trials that are designed and funded by the National Institute of Health. These include the Maternal-Fetal Medicine Units Network trials as well as a trial designed by the Genomic and Proteomic Network for Preterm Birth Research. While you are evaluated in the Utah Preterm Birth Prevention Clinic, you will be offered the chance to participate in cutting edge research designed to identify the causes of preterm birth and the optimal management of patients who are at risk.

Who should I contact if I have questions?

If you have a question or feel that you should be evaluated by a physician at the Utah Preterm Birth Prevention Clinic, please call the following contacts:

For patients to be seen at the University of Utah, please call the Maternal-Fetal Medicine office at (801) 581-8425. Alternatively, you could ask your current physician for a referral to the clinic and we would be happy to see you as soon as possible.

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Robert L. Andres, MD is an Associate Professor of Obstetrics and Gynecology at the University of Utah Health Sciences Center. Dr. Andres serves as an attending physician at McKay-Dee Hospital Center in Ogden, Utah, as well as the University of Utah Health Sciences Center . He completed his Maternal-Fetal Medicin... Read More

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Dr. Branch is a Maternal-Fetal Medicine specialist who treats high-risk pregnancy patients. He is internationally recognized for his research and focus on special interests within his specialty, including antiphosphilipid syndrome (APS), thrombotic disorders in pregnancy, and recurrent pregnancy loss. He has b... Read More

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Janice L.B. Byrne, MD is a Professor of Obstetrics and Gynecology at the University of Utah Healthsciences Center. Dr. Byrne is on the Steering Committe for the Utah Fetal Care Center at Primary Children's. She is on the faculty of the University of Utah Graduate Program in Genetic Counseling and serves as a cl... Read More

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Jeanette Chin, MD is an Assistant Professor in the Maternal-Fetal Medicine division of the Department of Obstetrics and Gynecology at the University of Utah Health Sciences Center. She is a native of Salt Lake City, Utah. She attended Rice University in Houston where she earned a B.A. in biochemistry. She receiv... Read More

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Erin Clark, MD has been an Assistant Professor of Obstetrics and Gynecology at the University of Utah Health Sciences Center since she completed her Maternal-Fetal Medicine Fellowship at the University of Utah in 2009. She is board certified in Obstetrics and Gynecology, as well as the subspecialty of Maternal-F... Read More

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Mark W. Dassel, M.D. is an Assistant Professor and women's health provider, with a special interest in Minimally Invasive Gynecology. Dr. Dassel received two B.S. degrees and an M.D. degree from the University of Kentucky. He completed an Obstetrics & Gynecology residency program at the Phoenix Integrated R... Read More

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Donna S. Dizon-Townson, MD is an Associate Professor of Obstetrics and Gynecology and serves as the Medical Director of Clinical Programs for the Southern Region of Intermountain Healthcare. Dr. Dizon-Townson is a renowned authority on thrombophilic disorders in pregnancy, having published several pioneering pap... Read More

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Michael L. Draper, MD is an Associate Professor of Obstetrics and Gynecology. He is board certified in Obstetrics and Gynecology, as well as the subspecialty of Maternal-Fetal Medicine. He has been with the University of Utah Maternal-Fetal Medicine Division since 2002. He is currently the Residency Program Dire... Read More

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Alexandra Grosvenor Eller, MD, MHP is an Assistant Professor of Obstetrics and Gynecology at the University of Utah Health Sciences Center. She is board certified in Obstetrics and Gynecology. Dr. Eller completed her Maternal-Fetal Medicine Fellowship at the University of Utah in 2008. Her areas of interest are ... Read More

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M. Sean Esplin, MD is an Associate Professor of Obstetrics and Gynecology. He joined the University of Utah Maternal-Fetal Medicine Division in 2000, after completion of his Maternal-Fetal Medicine Fellowship at the University of Utah. He is board certified in both Obstetrics and Gynecology and the subspecialty ... Read More

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Keri Gibson, MD, is a board-certified physician specializing in obstetrics and gynecology. She received her medical degree from the University of Virginia School of Medicine in 2005. She is a member of the American College of Obstetrics and Gynecology, and served as a Peace Corps volunteer in Mali, West Africa.... Read More

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Sarah is board Certified Nurse Midwife who has been faculty at the University of Utah College of Nursing from 2008-2012. After a short leave, Sarah chose to return to Utah to work within the Birthcare Healthcare practice again. Sarah has an active full scope midwifery practice and sees clients at South Jordan He... Read More

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Cara C. Heuser, MD is an Assistant Professor of Obstetrics and Gynecology at the University of Utah Health Sciences Center. She is an attending physician at Intermountain Medical Center in Murray, UT, as well as the UUHSC. She completed her Maternal-Fetal Medicine Fellowship at the University of Utah in 2011. Dr... Read More

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Calla M. Holmgren, M.D. is an Assistant Professor of Obstetrics and Gynecology at the University of Utah Health Sciences Center where she completed her fellowship in Maternal-Fetal Medicine in 2007. She is board certified in Obstetrics and Gynecology. Her special interests include diabetes, disorders of coagulat... Read More

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Marc Jackson, MD is an Associate Professor in the Department of Obstetrics and Gynecology at the University of Utah. Dr. Jackson graduated from UT Southwestern Medical School in Dallas, completed residency in Obstetrics and Gynecology at the University of Texas in San Antonio, and completed his fellowship in Mat... Read More

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Felicia Katz, MD., is a Board Eligible physician specializing in Obstetrics and Gynecology. She was born and raised in Eugene, Oregon, then lived in Los Angeles, California for many years while completing her medical training. She received her Bachelor’s degree in Biology from the California Institute of Technol... Read More

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Toni V. LaMalfa, C.N.M., is a certified midwife. She obtained a bachelor of science degree in nursing, and a master’s degree in nurse midwifery from the University of Utah. She is a member of the Utah chapter of the American College of Nurse-Midwives. LaMalfa specializes in all aspects of women’s health and prev... Read More

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Dr. Maclean’s clinical interests include women's health, obstetric care and general gynecology for women of all ages. She is accepting new obstetric patients into our group obstetrical practice and also provides services at the Greenwood University Hospital’s Community Clinic.... Read More

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Vicki L. Macy has been a Board-Certified Ob-Gyn physician for the past 27 years and is a Fellow of the American College of Obstetrics and Gynecology. She began her medical career at Oregon Health Sciences University in Portland Oregon where she graduated Cum Laud in 1981. This included an obstetrics rotation at... Read More

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Heather Major, MD is an Assistant Professor in the Department of Obstetrics and Gynecology at the University of Utah, where she completed her fellowship in Maternal-Fetal Medicine in 2010. Dr. Major's research interests include genetic factors which predispose to preterm birth, platelet and immune response in pr... Read More

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Rita Paegle, DNP, MSN, CNM, is a Certified Nurse Midwife at the University of Utah. She received her degree from the University of Utah. Her areas of clinical interest and expertise include international health care, policy, high risk obstetrics, health prevention and promotion, and OB triage. She is also fluen... Read More

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Dr. Park was born in Salt Lake City and grew up on a farm in Murray. He graduated from Granite High School. He went to college at the University of Utah and College of Medicine at the University of Utah. He specialized in Obstetrics and Gynecology, completing his residency at Fitzsimons Army Medical Center in D... Read More

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Dr. Pittman is a women's health provider and obstetrician gynecologist in the general obstetrics and gynecology division. Dr. Pittman’s clinical interests include general gynecology for women of all ages, and is accepting new obstetrical patients. She is accepting new patients at the Madsen Health Center for h... Read More

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T. Flint Porter, MD, MPH is an Associate Professor of Obstetrics and Gynecology at the University of Utah Health Sciences Center and Assistant Director of the Fellowship Training Program in Maternal-Fetal Medicine. He joined the Maternal-Fetal Medicine Division in 1997 after completing his fellowship at the Univ... Read More

Brandon L. Reynolds, D.O., is a board-certified obstetrician and gynecologist. He received his doctorate degree from Midwestern University’s Arizona College of Osteopathic Medicine in 2000. He is a Fellow of the American College of Osteopathic Obstetricians and Gynecologists. Dr. Reynolds’s professional interes... Read More

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Douglas Richards, MD is a Professor of Obstetrics and Gynecology at the University of Utah Health Sciences Center. He is Associate Residency Program Director of the Department of Obstetrics and Gynecology. He completed a fellowship in Maternal-Fetal Medicine at the University of North Carolina in 1987. He is boa... Read More

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Nancy C. Rose, MD is board certified in Clinical Genetics, Maternal-Fetal Medicine, and Obstetrics and Gynecology. She completed a Maternal-Fetal Medicine Fellowship at the Hospital of the University of Pennsylvania in 1992. A Professor of Obstetrics and Gynecology, she is also the Director of Reproductive Genet... Read More

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Howard T. Sharp, M.D. is an obstetrician and gynecologist at the University of Utah Health Sciences Center. Dr. Sharp provides women's health and has a special interest is in the treatment of chronic pelvic pain, and is the head of the Pelvic Pain Clinic located in the Women’s Pelvic Care Center at UUHSC. His ... Read More

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Robert M. Silver, MD is a Professor of Obstetrics and Gynecology at the University of Utah Health Sciences Center who joined the University of Utah Maternal-Fetal Medicine Division after completing his fellowship there in 1994. He is serving as the Chief of the Division of Maternal-Fetal Medicine and as Co-Dire... Read More

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Marilee Simons, M.D., is a board eligible obstetrics and gynecology physician. She received her bachelor’s degree in biology and chemistry from Carroll College in Helena, Montana, and obtained her medical degree from Creighton University in Omaha, Nebraska. She then completed residency training in obstetrics and... Read More

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Dr. Andrea N. Smith is an experienced physician specializing in women'shealthcare as an Obstetrician/Gynecologist. She earned an undergraduatedegree in Business Finance at the University of Colorado. She then went... Read More

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Amy E. Sullivan, MD has been an Assistant Professor of Obstetrics and Gynecology at the UUHSC since completing her Maternal-Fetal Medicine Fellowship there in 2003. She is board certified in Obstetrics and Gynecology and in Maternal-Fetal Medicine. Her interests include multiple gestations and maternal cardiac d... Read More

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Trece Swanson, DNP, CNM is a Certified Nurse Midwife at the University of Utah. She received both a Master of Science (MS) degree and a Doctorate of Nursing Practice (DNP) degree from the University of Utah. She is a board certified nurse-midwife, and a member of the Utah Chapter of the American College of Nur... Read More

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Dr. Thompson works as an obstetrician and gynecologist for the institution. Dr. Thompson's clinical interests include adolescent medicine, contraception, and menopausal care. Dr. Thompson is available for gynecologic consultations and new obstetrical patients. Dr. Thompson's research interests include: emergency... Read More

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Walter Townson, MD, is a board-certified physician specializing in obstetrics and gynecology. He received his undergraduate degree from Brigham Young University, and his medical degree from the University of Texas Southwestern. Dr. Townson is a fellow of the American College of Obstetrics and Gynecology and curr... Read More

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Dr. Trauscht- Van Horn is a women's health provider in the University of Utah Department of Obstetrics and Gynecology and is the Clinical Director of the Obstetrics and Gynecology Women’s Health and Breast Care Clinic. She also serves as the Medical Director for Planned Parenthood of Utah and is the Clinical Sup... Read More

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David Turok, M.D., is an Associate Professor in the University of Utah Department of Obstetrics and Gynecology, and is board certified in Obstetrics and Gynecology and Family Practice. His areas of clinical interest and expertise include all aspects of women's healthcare, particularly family planning.... Read More

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Michael W. Varner, MD joined the Department of Obstetrics and Gynecology in 1987 and currently serves as Professor and Vice-Chair for Research. He developed the Obstetrics and Gynecology Research Network, a consortium of over 50 research personnel who conduct and administer the many clinical trial networks - bot... Read More

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Sandra Whitney, CNM is a Certified Nurse Midwife at the University of Utah. She received her degree from the University of Utah. Her areas of clinical interest and expertise include all aspects of women's healthcare, particularly high-risk pregnancies. ... Read More